Levels and patterns of HIV RNA viral load in untreated pregnant women.
OBJECTIVE
To assess pregnancy levels and patterns of HIV RNA in the absence of antiretroviral therapy, while appropriately adjusting for potential confounders, including maternal immune status and race.


METHODS
Data on > or = 1 antenatal HIV RNA measurements were available for 333 untreated HIV-infected pregnant women enrolled in the European Collaborative Study. CD4 counts and HIV RNA measurements were routinely collected from 1992 and 1998, respectively. Linear mixed effects models based on 246 women for whom complete data were available examined changes in HIV RNA levels over pregnancy, with a nested random effects term accounting for measurement variability within women and period of sample collection.


RESULTS
The change in HIV RNA over pregnancy varied significantly by race (p=0.005): from the second trimester until delivery, HIV RNA decreased significantly by an estimated 0.019 log(10) copies/ml/week in white women (95% CI -0.03, -0.007); in black women the estimated 0.016 log(10) copies/ml/week increase (95% CI -0.005, 0.037) was not statistically significant. At delivery, HIV RNA levels in black women were 0.45 log(10) copies/ml higher (95% CI 0.08, 0.83) than in white women.


CONCLUSIONS
Our findings suggest that HIV RNA dynamics over pregnancy differ by race, although other interpretations cannot be excluded, due to potential for unmeasured confounding.
Patel
Deven
D
Thorne
Claire
C
Newell
Marie-Louise
ML
Cortina-Borja
Mario
M
D000293:Adolescent; D000328:Adult; D044466:Asian People; D044383:Black People; D018791:CD4 Lymphocyte Count; D005260:Female; D005865:Gestational Age; D015658:HIV Infections / Q000188:drug therapy / Q000208:ethnology / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000208:ethnology / Q000276:immunology / Q000821:virology; D012367:RNA, Viral / Q000097:blood*; D019562:Viral Load; D044465:White People; D055815:Young Adult
D012367:RNA, Viral